Challenges in recruiting participants in a multi-centre study on symptom experiences and self care strategies of bowel symptoms following colo-rectal surgery

Aim: the purpose of this paper is to present some of the challenges found to be problematic in recruiting individuals following sphincter-saving surgery for rectal cancer for a multi-centre study. While the focus of the study is on symptom experience and self-care strategies of bowel symptoms following colo-rectal surgery, the paper will concentrate solely on the challenges experienced in recruiting a sample for the study.Background: recruitment of an adequate number of participants is a challenge for researchers in any area of research involving patients. Enrolment of patients treated for rectal cancer poses particular challenges, because the total population of this group in a given country can be small. The use of multiple centres was required to obtain the required number of participants for the current study.Findings: in multi-centre studies, researchers can encounter substantial challenges in obtaining ethical approval, accessing clinical sites and gaining direct access to patients. These challenges are embedded in a convoluted process involving many systems of communication, which can vary from one centre to another.Conclusions: the process of obtaining ethical approval is prolonged in the absence of a central ethical review committee. A central review process based on a standard application for researchers seeking ethical approval for multi-centred studies is necessary. Establishing and maintaining access to clinical sites requires co-operation from many individuals during the development of the proposal and continuing throughout the data collection process.